Adverse Course of Listeria monocytogenes Infection in Pediatric Patient with T-Cell Acute Lymphoblastic Leukemia

Abstract

Oncological patients are at an increased risk of an opportunistic infection caused by Listeria monocytogenes. Listeriosis remains infrequent in oncological patients. This article describes a case report of a 15-year old boy diagnosed with T-ALL, who developed L.monocytogenes infection during an intensive cancer treatment. The patient's treatment proceeded with numerous complications. Impaired coagulation led to genetic examination and factor V Leiden and heterozygotic C667T and A1298C mutations of MTHFR detection. Corticosteroid therapy resulted in insulin resistance and hyperbilirubinemia with normal hepatic enzymes level. Gilbert's syndrome was confirmed. CT evaluating remission revealed asymptomatic invasive pulmonary aspergillosis. After finishing Protocol II the rise in CRP was observed with decreased number of WBC. Patient was feverish and complained of nonspecific abdominal pain and dysuria. USG detected fluid in right iliac fossa. A few hours later boy's neurological state dramatically worsened. CT revealed acute hydrocephalus, which needed immediate drainage. Listeria monocytogenes was isolated from CSF. Despite intensive antibiotic therapy, infection caused boy's death.